Prudence R Carr1, Barbara L Banbury2, Sonja I Berndt3, Peter T Campbell4, Jenny Chang-Claude5, Richard B Hayes6, Barbara V Howard7, Lina Jansen1, Eric J Jacobs4, Dorothy S Lane8, Reiko Nishihara9, Shuji Ogino10, Amanda I Phipps11, Martha L Slattery12, Marcia L Stefanick13, Robert Wallace14, Viola Walter1, Emily White15, Kana Wu16, Ulrike Peters17, Andrew T Chan18, Polly A Newcomb15, Hermann Brenner19, Michael Hoffmeister20. 1. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany. 2. Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington. 3. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland. 4. Epidemiology Research Program, American Cancer Society, Atlanta, Georgia. 5. Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany; Genetic Tumour Epidemiology Group, University Medical Center Hamburg-Eppendorf, University Cancer Center Hamburg, Hamburg, Germany. 6. Division of Epidemiology, Department of Population Health, New York University School of Medicine, New York, New York. 7. Department of Medicine, Georgetown University, Washington, DC. 8. Department of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, New York. 9. Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. 10. Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts; Broad Institute of MIT and Harvard, Cambridge, Massachusetts; Department of Epidemiology, Harvard T.H Chan School of Public Health, Boston, Massachusetts. 11. Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, Washington. 12. Department of Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah. 13. Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California. 14. Department of Epidemiology, University of Iowa, Iowa City, Iowa. 15. Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, Washington. 16. Department of Nutrition, Harvard T.H Chan School of Public Health, Boston, Massachusetts. 17. Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington. 18. Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. 19. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center, Heidelberg, Germany; German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany. 20. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany. Electronic address: m.hoffmeister@dkfz.de.
Abstract
BACKGROUND & AIMS: Red and processed meat intake is associated with colorectal cancer (CRC) incidence, but it is not clear if intake is associated with patient survival after diagnosis. METHODS: We pooled data from 7627 patients with stage I-IV CRC from 10 studies in the International Survival Analysis in Colorectal Cancer Consortium. Cox proportional hazards regression models were used to evaluate the associations of intake of red and processed meat before diagnosis with overall and CRC-specific survival. RESULTS: Among 7627 patients with CRC, 2338 died, including 1576 from CRC, over a median follow-up time of 5.1 years. In multivariable-adjusted analyses, higher intake of red or processed meat was not associated with overall survival of patients with stage I-III CRC: Q4 vs Q1 red meat hazard ratio [HR], 1.08 (95% CI, 0.93-1.26) and Q4 vs Q1 processed meat HR, 1.10 (95% CI, 0.93-1.32) or with CRC-specific survival: Q4 vs Q1 red meat HR, 1.09 (95% CI, 0.89-1.33) and Q4 vs Q1 processed meat HR, 1.11 (95% CI, 0.87-1.42). Results were similar for patients with stage IV CRC. However, patients with stage I-III CRC who reported an intake of processed meat above the study-specific medians had a higher risk of death from any cause (HR, 1.12; 95% CI, 1.01-1.25) than patients who reported eating at or less than the median. CONCLUSION: In this large consortium of CRC patient cohorts, intake of red and processed meat before a diagnosis of CRC was not associated with shorter survival time after diagnosis, although a possible weak adverse association cannot be excluded. Studies that evaluate dietary data from several time points before and after cancer diagnosis are required to confirm these findings.
BACKGROUND & AIMS: Red and processed meat intake is associated with colorectal cancer (CRC) incidence, but it is not clear if intake is associated with patient survival after diagnosis. METHODS: We pooled data from 7627 patients with stage I-IV CRC from 10 studies in the International Survival Analysis in Colorectal Cancer Consortium. Cox proportional hazards regression models were used to evaluate the associations of intake of red and processed meat before diagnosis with overall and CRC-specific survival. RESULTS: Among 7627 patients with CRC, 2338 died, including 1576 from CRC, over a median follow-up time of 5.1 years. In multivariable-adjusted analyses, higher intake of red or processed meat was not associated with overall survival of patients with stage I-III CRC: Q4 vs Q1 red meat hazard ratio [HR], 1.08 (95% CI, 0.93-1.26) and Q4 vs Q1 processed meat HR, 1.10 (95% CI, 0.93-1.32) or with CRC-specific survival: Q4 vs Q1 red meat HR, 1.09 (95% CI, 0.89-1.33) and Q4 vs Q1 processed meat HR, 1.11 (95% CI, 0.87-1.42). Results were similar for patients with stage IV CRC. However, patients with stage I-III CRC who reported an intake of processed meat above the study-specific medians had a higher risk of death from any cause (HR, 1.12; 95% CI, 1.01-1.25) than patients who reported eating at or less than the median. CONCLUSION: In this large consortium of CRC patient cohorts, intake of red and processed meat before a diagnosis of CRC was not associated with shorter survival time after diagnosis, although a possible weak adverse association cannot be excluded. Studies that evaluate dietary data from several time points before and after cancer diagnosis are required to confirm these findings.
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